MEDICARE: ELGIN DISCOUNT PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy
2	3336C0003X	Community/Retail Pharmacy	35152	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2073849	OTHER		PK

General Provider Information

NPI Number	:	1669487534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELGIN DISCOUNT PHARMACY INC

Provider Business Mailing Address
First Line	:	7523 US HIGHWAY 277
Second Line	:
City	:	ELGIN
State	:	OK
Zip	:	73538-2161
Country	:	US
Telephone Number	:	580-492-5007
Fax Number	:	580-492-5090

Provider Business Practice Location Address
First Line	:	7523 US HIGHWAY 277
Second Line	:
City	:	ELGIN
State	:	OK
Zip	:	73538-2161
Country	:	US
Telephone Number	:	580-492-5007
Fax Number	:	580-492-5090

Authorized Official
Title or Position	:	OWNER AND PRESIDENT MNGR
Name	:	MARK DEEVERS
Credential	:
Telephone Number	:	580-492-5007

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	06/08/2015

Similar Medicare Providers

1376930081 — DR. BRENDAN JONES PHARMD
Practice Location Address:

7523 US HIGHWAY 277
ELGIN, OK
73538-2161

Practice Phone: 580-492-5007
Practice Fax: 580-492-5090

1700569415 — OPTIMUM DENTAL OF ELGIN, PLLC
Practice Location Address:

12885 COMMERCE DR
ELGIN, OK
73538-3869

Practice Phone: 405-206-2916
Practice Fax:

1326033259 — DR. ANTHONY LLOYD ORME MD
Practice Location Address:

505 8TH ST
ELGIN, OK
73538

Practice Phone: 580-492-6900
Practice Fax: 580-492-6902

1184609042 — MS. JULIE DAWN MILBURN FNP
Practice Location Address:

11269 NE JERE LAYNE
ELGIN, OK
73538-3811

Practice Phone: 405-488-7715
Practice Fax:

1821076506 — VICTORY HOSPICE, INC.
Practice Location Address:

104 THOMA DR STE 1
ELGIN, OK
73538-2203

Practice Phone: 580-492-6166
Practice Fax: 580-492-6160

1497733182 — VICTORY HOME HEALTH, LLC
Practice Location Address:

104 THOMA DR STE 1 , BOX 769
ELGIN, OK
73538-2203

Practice Phone: 580-492-6166
Practice Fax: 580-492-6160

Directions to “ELGIN DISCOUNT PHARMACY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.